43 minutes ago

It’s time for Democrats to play offense on healthcare | Abdul El-Sayed

You don’t need a doctor to tell you America’s healthcare system is broken, but I’ll tell you anyway. Having led two public health departments, I’ve seen first-hand the struggles that working people face trying to survive in a system that has become unaffordable and purposely confusing.

We all feel it. Most of us feel it when we try to schedule an appointment. Others feel it when we wait hours for eight minutes with a provider. Worst of all, we feel it when we face bills we can’t pay – despite being insured.

Republicans are dead set on destroying the Affordable Care Act. They are proving it with cuts to Medicaid and ACA subsidies. That’s why it’s not enough for Democrats to play defense. We need to go on offense for the kind of healthcare system Americans actually deserve. And that is nothing short of the full elimination of medical debt – and guaranteeing healthcare through Medicare for All.

For the last 15 years, Republicans have taken a sledgehammer to what little stability we have, all to boost their big insurance and big pharma donors. After a government shutdown over expiring ACA tax credits, many Republicans now seem hellbent on eliminating ACA tax credits altogether, effectively pricing millions out of coverage. When people are forced out of the system, they still need healthcare. They get it in emergency rooms – after their illness has progressed. That care isn’t free; its costs just get shifted on to the rest of us.

The consequences of the end of ACA subsidies will pale in comparison to the $1tn in cuts to Medicaid they are making. Together, the moves point to a full-blown catastrophe. About 2.3 million people in my home state of Michigan use Medicaid. Americans with disabilities and seniors will lose the care they depend on. Medicaid covers 39% of children in Michigan. In town halls across the state, I’ve heard directly from the folks affected by hospital closures in rural communities. There’s no way to sugar-coat these realities.

At this breaking point, Democrats must meet the moment with a solution that matches the scale of the crisis: we can eliminate America’s staggering $220bn in medical debt for pennies on the dollar. We did it for all of Wayne county when I was health director. And if Michigan’s largest county can do it, so can the rest of the country. But it’s not enough to erase debt – we have to protect Americans from accruing it in the first place. That means guaranteeing every American healthcare through Medicare for All.

Medicare for All means a guaranteed comprehensive government health insurance program without copays, premiums, or deductibles that is available to every single American from cradle onwards and does not exclude additional employer or union-sponsored plans as add-ons. It would protect Americans from all the ways they can lose healthcare now – including turning 26, losing a job, getting divorced or turning 65. Because it decouples employment from health coverage, people wouldn’t be punished for changing jobs. Folks who like their private insurance, through an employer or a union, could keep it as an add-on to the public plan. But they would still be still protected if they lost that job or their factory closed down.

Medicare for All would bring down healthcare costs across the board by eliminating the middle-man in healthcare. It would also eliminate the overhead that doctors’ offices, hospitals, and healthcare systems have to sustain simply because of the complexity of billing. By fully expanding the government’s power to negotiate drug prices on our behalf, Medicare for All would also reduce prescription drug prices.

Expanding Medicare to cover all Americans would make the program stronger and more sustainable for seniors. It would expand the pool with younger, healthier people paying into the system.

It would be good for business, too. Medicare for All could unleash a flurry of entrepreneurship by freeing Americans with great business ideas from dead-end jobs they stay in simply for the health insurance.

When eight Democratic senators caved on the shutdown in the face of mounting healthcare costs, it showed that the current iteration of the party isn’t as serious as the problems they claim to be fighting against. Mounting an offensive for expanding healthcare coverage, not just defending against Republican attacks, could spur the kind of attention and excitement that Democrats need heading into the midterms.

That’s what I’m doing here in Michigan. I’ve seen what functional government can do for real people. I’ve made it happen myself. Americans are sick of being screwed over by their own government. This is about building trust that Democrats have the vision and grit to actually deliver for Americans. And we gain that trust by delivering marked results. It’s not enough to continue to leave Americans with scraps and expect them to thank us. We need leaders who have the courage and vision to deliver the healthcare system we all deserve.